The main objective of this study is to investigate the effects of industrialization, economic growth, and globalization processes on the ecological footprint and healthcare expenditures in the ten countries with the highest healthcare expenditures from 1995-2018 using the Stochastic Impacts by Regression on the Population, Affluence, and Technology (STIRPAT) framework. In order to estimate the influence of these variables, this study applied a second-generation approach after confirming the possible cross-sectional dependency across countries. The findings indicate that industrialization, healthcare expenditures, and economic growth are more responsible for increasing the pollution level. In contrast, globalization and the urbanization process significantly reduce environmental damage. Moreover, the ecological footprint, urban population, industrialization, and economic growth increase healthcare expenditures while globalization reduces them. In addition, the causality test discovered that bidirectional causality exists between healthcare expenditures, the urban population, industrialization, and the ecological footprint. Furthermore, unidirectional causality is discovered from economic growth and globalization to the ecological footprint. Moreover, the conclusions are robust to various robustness checks that we executed to examine the reliability/accuracy of our main findings. Based on the empirical findings, several policy implications are suggested for these countries with high healthcare expenditures. (C) 2021 Institution of Chemical Engineers. Published by Elsevier B.V. All rights reserved.
